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4 - Narrating the treatment: the formulation, reformulation and therapeutic contract

Published online by Cambridge University Press:  06 November 2009

Digby Tantam
Affiliation:
University of Sheffield
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Summary

Narrative approaches to psychotherapy have become rapidly established in family therapy (Sluzki, 1992), and are increasingly influencing individual psychotherapy. They recognize that the need to tell one's story is an important impulse for people in distress, and that telling one's story to a receptive audience lifts some of the burden of the events depicted in it.

Narratives bring together the three elements that we have already seen contribute to a person's concerns: actions, values and emotional meaning. Indeed, literary narratives have been viewed as responses to fundamental concerns, and a limited range of them at that. Illness is one of these concerns, and ‘taking a history’ is a narrative response to it which will be familiar to all doctors.

The ‘narrative turn’, as it has been called, in the intellectual life of the twentieth century reflected the weakening of a commonsense world of reality to be discovered, and replaced it with reality which was constructed and, potentially, deconstructed. The early psycho-analysts were strong influences on the development of the narrative approach because of their emphasis on the hidden reality of the ‘unconscious’. However, these early psycho-analysts were not free of their positivist inheritance, and believed that they were describing a psychic reality. Narrative theory has grown sufficiently large, however, to be able to bite the hand that fed it, and to challenge this reality. Surely, narrative theorists would argue, the unconscious is just another story?

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Psychotherapy and Counselling in Practice
A Narrative Framework
, pp. 81 - 118
Publisher: Cambridge University Press
Print publication year: 2002

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